Health Minister Deb Matthews has asked experts to look at systems, including peer review, that could prevent more misdiagnosed digital images.

Ontario’s health minister says she wants tougher quality control measures for diagnostic imaging in the wake of the controversy over misread scans at Trillium Health.

“I think we can strengthen quality assurance when it comes to radiology,” Deb Matthews said on Thursday.

She said she convened a meeting on Wednesday with key players in the health system to discuss the idea. Attendees included representatives from the Ontario Hospital Association, Ontario Medical Association, College of Physicians and Surgeons of Ontario and the Ontario Association of Radiologists.

“I really wanted to hear from them about what they thought needed to be done, (with options) ranging from nothing because everything is fine to a serious overhaul,” she said.

“There was a strong consensus that there is more we can do particularly around peer review,” Matthews added, noting she asked the officials to get back to her as soon as possible with advice.

Trillium Health last week sent letters to about 3,500 patients, alerting them that their CT scans and mammograms were being reviewed because it has been discovered that the original radiologist who read them has been making errors.

The radiologist, Dr. Ivo “Ivan” Slezic, stopped working after his privileges were restricted on April 1.

Trillium said that it was through its own quality assurance program that mistakes were discovered. The hospital’s chief of radiology peer-reviewed some of Slezic’s work and found some errors.

An internal investigation then revealed clinically significant interpretive errors in three scans.

The three patients were rescanned. While no critical issues were found with two, the third patient was affected in terms of when treatment was commenced.

It’s unclear exactly how many patients are so far known to be affected.

Another patient, 28-year-old Houda Rafle, was last month diagnosed with stage-four cancer after Slezic failed to notice a tumour near her heart on a CT done back in March. That mistake was picked up because Rafle continued to feel unwell and sought medical treatment that included a new CT scan.

The controversy has sparked calls for province-wide standards in quality assurance in radiology, particularly peer review. Currently, quality assurance decisions are made by individual hospitals. Some hospitals like Trillium have already started to introduce peer-review programs.

“Some hospitals are really demonstrating a strong commitment to improving quality. I just think all patients in Ontario should have access to care that is of the highest possible quality,” Matthews said.

The provincial New Democrats, Canadian Cancer Survivor Network and medical practice lawyers say Ontario should follow British Columbia and Alberta in setting up more rigorous peer-review programs in diagnostic imaging.

Those provinces are in the midst of setting up stronger quality controls following similar controversies over misread scans and misdiagnosed patients.

Matthews said it is premature to say whether there will be peer review of all radiology work in Ontario, but it is under serious consideration.

One stumbling block would be cost. The province is trying to keep a lid on the ever-increasing health budget and has frozen funding to hospitals.

Province-wide peer review would cost many, many millions of dollars with investments needed in computer software and hardware, according to experts.

Matthews said she is prepared to make an investment.

“I am convinced that improving quality in the long term reduces costs. For me, it’s in that sweet spot, better care for patients and better value for money,” she said.

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